My medical skills add experience

Chapter 243 Controversy
"That's fine! I've been waiting for more than a year, and I don't care about this day. Please take care of me." The woman nodded and agreed.

The cause of the disease was found out, which was the most exciting news for her.

It also gave her hope.

After suffering for so long, she finally saw the light.

"Xiaoqiu, you help send the patient back to the temporary bed. You all go to your own business!"

After Director Shang communicated with the family members, he directly ordered Qiu Chengyu to do chores.

After two days, Zhou Can has established a relatively stable position in the Department of Gastroenterology.No matter in Director Shang's mind or in Huang Xinggui's eyes, they no longer dare to treat him as an ordinary trainee.

Director Shang didn't say anything, but his respect for Zhou Can was reflected in some details.

"I have to coordinate and arrange the operation. Zhou Can, can you take care of this patient?"

I thought the bed doctor had already been assigned.

Unexpectedly, Zhou Can was given another patient.

"Okay! I have no problem taking care of four patients." Zhou Can has been stuffed with four patients so far.

The task is not heavy, nor is it light.

Generally speaking, there are no critically ill patients in the Department of Gastroenterology, and there are ten beds in charge at the same time, so the pressure will not be particularly high.The workload is definitely not small.Just writing medical records and courses, changing medicines, and making ward rounds are enough to keep people busy.

I really don’t know what is the concept of a Gui Peisheng managing [-] or [-] beds in some hospitals?
Under normal circumstances, one person would definitely not be able to take care of it.

The quality of medical care has declined sharply, and templates for writing medical records are almost certain.

"By the way, the condition of the female lawyer in bed 79, is it convenient to discuss with you now?" Zhou Can has already found out the cause of the female patient, but he has been busy in the afternoon and has no chance to discuss it with Director Shang. .

"Oh! That patient's diagnosis has also made significant progress?"

Director Shang was surprised and surprised after hearing this.

This Gui Peisheng is really good, no wonder the departments that have been rotated are rushing to keep people.

"After taking over the patient in the morning, I have been wondering how her liver cirrhosis was formed? Later, I accidentally discovered that she occasionally had diarrhea..."

Zhou Can explained his own diagnostic thinking.

"To sum up, I suspect that the patient has portal vein thrombosis. If we can do a splenic portal venography, we can diagnose whether it is the disease!"

Which tests to apply for is generally decided by the attending physician.

Zhou Can is just a regular trainer in charge of the bed, who has the right to make suggestions but not the right to make decisions.

"If this is the case, the symptoms would not be so mild. The progression of portal vein thrombosis is generally very rapid. If it is combined with mesenteric vein thrombosis at the same time, the patient often dies within a very short time. According to her, abdominal discomfort , loss of appetite, and fatigue symptoms for at least one month, which are too mild compared with the symptoms of portal vein thrombosis."

Director Shang did not agree with Zhou Can's diagnosis.

Portal vein thrombosis is like a ferocious tiger, but the disease that the patient's symptoms match is as gentle as a sheep.

The styles of the two are very different.

"I also thought about this problem at the time. After thinking about it carefully, I think that the patient may belong to the type of slow portal thrombosis. This kind of thrombus can form collateral circulation, and the portal vein can be recanalized, although eventually It progresses to portal hypertension. But it is much milder than ordinary portal thrombosis. The time span can also be extremely long."

Zhou Can had already thought about this question.

After thrombus occurs, multi-chamber diversion of the portal vein is also a relatively common phenomenon.

The human body is far more tenacious than we think.

It is like a super castle, with various warning and defense mechanisms.

But when a part is breached by the enemy, other parts can automatically replace part of the functions of this part.This will ensure that the body will not be too fragile.

Human beings have a history of at least 650 million years from ancient times to the present.

In these long years, to be able to survive to this day and become the overlord on the earth, the vitality of human beings is far more tenacious than imagined.The body's various defense mechanisms are also extremely complete.

Many people think that the human body is just that, isn't it just two eyes, a nose and a mouth?
Under the skin are the muscles, and there are various organs in the chest and abdominal cavity.

It's all obvious, nothing out of the ordinary.

In fact, there are many unsolved scientific mysteries in human body organs, even in any cell.For example, the human body is born with various proto-oncogenes and at the same time carries tumor suppressor genes.

In other words, cancer has been with each of us since we were born.

But most people's tumor suppressor genes can protect the body very well and suppress all proto-oncogenes.When a cell wants to rebel, mutate, and become a cancer cell, the tumor suppressor gene can directly kill it in the cradle.

And it is 100% accurate, there is no fish that slipped through the net.

Only when a person's tumor suppressor gene fails, or disappears, is there a risk of cancer.

There is only this risk.

It doesn't mean you have cancer.

The magic of the human body is not just the enemies of proto-oncogene and tumor suppressor gene.There are also skins that we think are ordinary, but also have magical abilities that we can't imagine.

For example, the tactile sensation of the skin is beyond imagination.

Close your eyes and reach out to touch it, and you can immediately tell whether the surface of the thing you touch is smooth, what kind of material it is, whether the temperature is hot or cold, and how thick it is...

Even today's most advanced science and technology cannot imitate the human skin perception ability.

When something we touch is hot, the brain immediately receives a 'hot' signal.

At this time, you will quickly hide from that object and stay away from it, so as to avoid your body being burned.

Or if you touch a sharp object, it will cause a frightening sting, and you will avoid it immediately.

The human skin is capable of so much.

In addition to having a sense of touch like the power of God, it can also help humans resist the invasion of bacteria and viruses.It also keeps the body hydrated.When our body is in an overheated environment, it can also regulate body temperature by evaporating water.When it is cold, it can shrink the capillary pores and lock the body temperature without loss.

From this point of view, it is equivalent to an 'air conditioner' for the human body.

There are too many miraculous organs like the skin in the human body to count.

Some people speculate that humans are descended from aliens.

No creature on earth is more amazing and complex than man.

Zhou Can believes that human beings are more powerful than alien creatures.

According to the current development speed, it is possible to conquer the entire solar system, even the Milky Way, and the entire universe.

In fact, human beings have already entered the interstellar era.

It's just in its infancy.

After listening to Zhou Can's point of view, Director Shang began to ponder again.

After four or five minutes, he seemed to have finally sorted out the clues.

"Your analysis makes sense. I'll observe the patient's condition again. If there is no new discovery, I will do as you said. Give her an venous angiography."

In the end, Director Shang still couldn't make up his mind.

Decided to observe the situation one more night.

There was no way to do angiographic examination today.

Unless the patient has any emergencies, angiography must be done immediately to save lives.Only then would it be possible to ask the teachers of the intervention department to temporarily add an evening shift.

Zhou Can was just making suggestions anyway, and he had no way to decide whether Director Shang would accept them or not.

If you do your job well, that's pretty good.

I have been working and studying in the outpatient clinic in the afternoon, and I don't know how the three-bed patients are doing?

Before leaving, he handed over the patient to Mr. Luo for management.

There will be no big mistakes.

Zhou Can first checked the gastric cancer patients in bed 77, and the signs were stable.

"Doctor Zhou, you are here!"

Patients have endless gratitude and deep trust in him.

Seeing Zhou Can enter the ward was like seeing a relative.

In fact, Zhou Can just bought her a meal.

"There haven't been any major changes in the body? For example, which part is particularly painful."

Zhou Can asked gently.

"It doesn't feel any different than usual. I had a stomach upset for a while, but it's much better now."

Her stomach cancer is still at an early stage, so there will be no unbearable severe pain.

When the cancer is in the advanced stage, the most frightening thing is the pain that goes deep into the bone marrow.

It can make people want to commit suicide.

Because it hurts too much.

"Rest well, wait for your mother to come, and try to choose active treatment at that time. Your disease is treated now, and there is a great hope of being cured. At that time, you can start a new life again, be a confident and self-improving woman, and repay it well your mother."

Zhou Can can only use her relatives to awaken her desire to survive.

In the fight against cancer, it is also very important to maintain a positive and optimistic attitude.

"Thank you! I am so lucky to have met such a good doctor as you!" As she spoke, she burst into tears again.The voice was also choked several times.

Zhou Can sighed.

What a wonderful girl, just ruined by that vicious man who didn't know how to cherish her.

He walked to bed 79 to check the situation of the female lawyer.

Not bad, the patient's signs are also quite stable, and there are no emergencies.

Zhou Can came to another ward to check on the patients in bed 71.

This patient with esophagus-jejunum anastomotic leakage and occlusion of the anastomotic segment is receiving nutritional injections again.

No way, he couldn't even drink a sip of water, so he had to rely on intravenous infusion to hang his life.An operation will be arranged for him tomorrow, so there is no need to worry too much.

"Ah yo... ah yo..."

73 There was a humming sound from the other side of the bed.

Zhou Can turned his head to look, and saw the couple singing the oboe in tacit understanding.You just finished humming my debut.

The patient kept humming and shouting for pain, which he could understand.

I had just completed pancreatic duct stone removal surgery and was infected with salmonella again.In the absence of drug treatment, the patient's body can only rely on hard resistance.

It's just that the patient's wife, that is, the aunt who didn't listen to persuasion, also hummed. What's going on?
This aunt is definitely not joking.

He was lying on the edge of the bed in pain, his face was full of pain, and he kept humming, indicating that his stomach hurt badly.

"What's the matter with you?"

Zhou Can walked over and asked with concern.

"Don't mention it, it may be because I also drank that pot of chicken soup. Not long ago, I started to have a stomachache. It has been hurting until now, and it is getting worse and worse."

The aunt was trembling with pain.

After Salmonella infection, some people get sick early, and they start to get sick within [-] or [-] hours.Some people may have stronger body resistance and a small number of Salmonella infections.This may lead to a longer incubation period.

But one thing is certain, as long as you are infected, the onset will happen sooner or later.

"Didn't you get tested for Salmonella?"

Zhou Can asked.

"I haven't... done it yet! It's not easy for the two of us to earn some money, so we can save some money if we can. My health has always been good, and the resistance will pass."

The aunt was lying on the head of the bed, talking intermittently.

It can be seen that the pain is quite severe.

She had followed her husband to the hospital to take care of the operation, but now, her husband was put down by the poisonous chicken soup she bought, and she herself was not spared.It became two patients at once.

It's just that this aunt is really able to resist, and she will not go to the front line if she is slighted, and she will continue to fight if she is seriously injured.

Anyway, she just stayed in front of her husband's hospital bed, gritted her teeth and held on.

Zhou Can was full of sympathy for the couple, but also helpless.

It was because she thought she was smart and didn't follow the doctor's advice, which caused such a disaster.

After something went wrong, she still didn't listen to the doctor's advice, and she was lucky.

To put it bluntly, poor people must have something to hate.

"Infected with salmonella, sometimes it doesn't depend entirely on whether the body is strong. If your symptoms worsen, I suggest that you still receive regular treatment to avoid serious consequences. This disease, some people can resist it, and some people may have a worsening condition , leading to sepsis, typhoid fever, and sepsis, and at that point, the fatality rate is very high.”

Zhou Can really wasn't trying to scare her.

This disease varies from person to person.

After some strong men are infected, they deteriorate rapidly and die soon.

Some seemingly emaciated people contract the disease and survive it.

It mainly depends on whether the body's immune mechanism can be activated in time.Especially the third immune mechanism, whether the helper cells can successfully activate a large number of inactivated macrophages.

This is very critical.

If the body is ravaged by salmonella to a certain extent, macrophages are still not fully activated, which is dangerous.

A large number of cells are killed by Salmonella, which can lead to necrosis of intestinal tissue.

The pathological mechanism at this time is similar to that of necrotic limbs that cannot be amputated in time.

Prognosis will be very poor.

"I'll take a look first... Thank you!"

Aunt can't persuade at all.

Her husband was lying on the hospital bed, just humming to himself, and didn't care about it at all.

Maybe you don't want to care about it at all.

Not a family, do not enter a door.The wife's thinking is backward, and the husband's thinking may not be much advanced.

Zhou Can has fulfilled his duty as a doctor, and since his family members refuse to listen, there is nothing he can do.

At this time, the aunt's face changed, and she took the half-used paper towels from the bedside table, covered her stomach and ran outside.

One of the major symptoms of Salmonella infection is diarrhea.

If you run too slowly, you must pull it in your crotch.

Zhou Can shook his head helplessly and walked out of the ward.

It was time to get off work, and he was going to get off work after handing over to the doctor on duty.

Ordinary regular Pearson needs to work overtime, and it is normal. His status is a bit special, and no one has arranged for him to work overtime for the time being.

"Doctor Zhou is taking care of my patients again!"

At this time, Dr. Yu Xin in the group walked into the ward quickly.

Looking at her light steps, it means that she can leave the morning shift today.

After getting acquainted with Zhou Can, she will no longer keep a cold face and admire herself alone.

For now, it is very rare to take the initiative to say hello to Zhou Can.

"I just took a look. His condition has improved, his body temperature has not risen, and his complexion is better than before. It is estimated that by tomorrow morning, his abdominal pain and diarrhea will be much relieved."

Zhou Can gave her feedback on his opinions.

"Great!"

She had surprisingly trust in Zhou Can's diagnosis opinion.

Hearing that the patient's condition had improved, a rare smile appeared on his face.Just charged quickly.

Maybe, she doesn't like to laugh by nature.

"His condition is improving, but his wife's condition is temporarily unknown. When I came just now, his wife had a severe stomachache and had already gone to the toilet because of diarrhea. I suggested that she have an examination and receive regular treatment. She won't listen. You can persuade him when you see someone later. This disease is just in case."

Zhou Can mentioned to her about the patient's wife again.

It was really earnest, and it was all for the sake of that aunt.

"I have already persuaded her. I can't persuade her! It's okay. I will pay close attention to her condition during the rounds. If her condition worsens, I will persuade her to receive treatment, and she may listen."

When Yu Xin mentioned that aunt, she also looked helpless.

"Okay, I'll go to the office to finish writing the medical records, and I'll get off work after handover. Goodbye."

Zhou Can no longer cares about this matter.

He has a lot to do with himself.

Go back to the office and finish writing the medical records of several patients, and prepare to leave after get off work.

As soon as he went out, he ran into Director Shang who came out of the director's office. Judging by his expression, he seemed a little unhappy.

"Director Shang, I'm off work!"

"Well! Be careful on the road. Tomorrow morning, the patient in bed 71 will have an endoscopic surgery. Remember to make arrangements for him when you come in the morning."

Director Shang was very gentle when speaking to Zhou Can.

"Okay! Can the patient with parasites in the brain be operated on tomorrow?"

Zhou Can asked a question.

"I'm afraid it won't be arranged tomorrow. Just now I called the general surgeon to coordinate, and they said that the intracranial surgery needs to be done by a divine surgeon. Then I went to the neurosurgery room and asked them to combine treatment, but the little nurse who answered the phone called me in a bureaucratic way and put I'm really pissed off."

Director Shang probably was really pissed off, otherwise he wouldn't have told his doctors about it.

(End of this chapter)